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Management of lepirudin therapy for a patient with antiphospholipid antibody syndrome using the whole blood ecarin clot time and activated partial thromboplastin time.

Publication ,  Journal Article
Perry, SL; O'Shea, SI; Ortel, TL
Published in: Blood Coagul Fibrinolysis
September 2003

A patient with antiphospholipid antibody syndrome (APS) and a history of heparin-induced thrombocytopenia required lepirudin therapy. The patient had an abnormal baseline activated partial thromboplastin time (aPTT), complicating management of his therapy. We investigated whether an alternative monitoring system, using a dry reagent technology [Thrombolytic Assessment System (TAS)], could be used to monitor the patient's whole blood ecarin clot time (ECT) and aPTT. Baseline values for the ECT and aPTT were normal with this system. During a continuous infusion of lepirudin, the patient's whole blood ECT was maintained between a desired range of 150-200 s for 73% of the time. Similarly, his whole blood aPTT was maintained between 60 and 80 s for 80% of the time. In contrast, the patient's plasma-based aPTT by standard methods was consistently > 150 s. The patient underwent surgical procedures without complications. To further investigate the finding that the patient's antibody did not affect the aPTT with this system, we performed the ECT and the aPTT assays on the TAS Analyzer with plasma samples from 10 patients with APS and abnormal aPTTs. All 10 samples had plasma ECT values within the normal range. Four patients had normalization of the aPTT, suggesting that a subset of patients with APS may benefit from the TAS aPTT assay when monitoring heparin or other anticoagulation therapy.

Duke Scholars

Published In

Blood Coagul Fibrinolysis

DOI

ISSN

0957-5235

Publication Date

September 2003

Volume

14

Issue

6

Start / End Page

601 / 604

Location

England

Related Subject Headings

  • Whole Blood Coagulation Time
  • Thrombocytopenia
  • Recombinant Proteins
  • Partial Thromboplastin Time
  • Middle Aged
  • Male
  • Humans
  • Hirudins
  • Heparin
  • Endopeptidases
 

Citation

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Perry, S. L., O’Shea, S. I., & Ortel, T. L. (2003). Management of lepirudin therapy for a patient with antiphospholipid antibody syndrome using the whole blood ecarin clot time and activated partial thromboplastin time. Blood Coagul Fibrinolysis, 14(6), 601–604. https://doi.org/10.1097/00001721-200309000-00014
Perry, Stephanie L., Susan I. O’Shea, and Thomas L. Ortel. “Management of lepirudin therapy for a patient with antiphospholipid antibody syndrome using the whole blood ecarin clot time and activated partial thromboplastin time.Blood Coagul Fibrinolysis 14, no. 6 (September 2003): 601–4. https://doi.org/10.1097/00001721-200309000-00014.
Perry, Stephanie L., et al. “Management of lepirudin therapy for a patient with antiphospholipid antibody syndrome using the whole blood ecarin clot time and activated partial thromboplastin time.Blood Coagul Fibrinolysis, vol. 14, no. 6, Sept. 2003, pp. 601–04. Pubmed, doi:10.1097/00001721-200309000-00014.

Published In

Blood Coagul Fibrinolysis

DOI

ISSN

0957-5235

Publication Date

September 2003

Volume

14

Issue

6

Start / End Page

601 / 604

Location

England

Related Subject Headings

  • Whole Blood Coagulation Time
  • Thrombocytopenia
  • Recombinant Proteins
  • Partial Thromboplastin Time
  • Middle Aged
  • Male
  • Humans
  • Hirudins
  • Heparin
  • Endopeptidases